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Vasovich, Inge

CPSO#: 23797

MEMBER STATUS
Expired: Resigned from membership as of 30 Sep 2016
CURRENT OR PAST CPSO REGISTRATION CLASS
None as of 14 Oct 2014

Summary

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Former Name: No Former Name

Gender: Female

Languages Spoken: English, German, Yugoslav

Education: Schulich School of Medicine and Dentistr, 1970

Practice Information

Primary Location of Practice
Practice Address Not Available

Medical Records Location

Address: Records Access Services Inc. (RASCI) Tel: 1-800-971-8038
Date Received: 04 Nov 2016

Specialties

Specialty Issued On Type
No Speciality Reported

Registration History

Action Issue Date
First certificate of registration issued: Postgraduate Education Certificate Effective: 01 Jul 1970
Transfer of class of registration to: Independent Practice Certificate Effective: 07 Jul 1971
Transfer of class of certificate to: Restricted certificate Effective: 14 Oct 2014
Terms and conditions imposed on certificate Effective: 14 Oct 2014
Terms and conditions amended by member Effective: 11 May 2015
Terms and conditions amended by Discipline Committee Effective: 30 Jun 2015
Suspension of registration imposed: Discipline Committee Effective: 30 Jul 2015
Suspension of registration removed Effective: 30 Nov 2015
Expired: Resigned from membership. Expiry: 30 Sep 2016

Previous Hearings

Committee: Discipline
Decision Date: 30 Jun 2015
Summary:

NOTICE OF PUBLICATION BAN
In the College of Physicians and Surgeons of Ontario and Dr. Inge Vasovich, this
is notice that the Discipline Committee ordered that no person shall publish or
broadcast the name of the patient or the patient’s family members, excluding Dr.
Vasovich, or any information that can identify the patient or family members under subsection 45(3) of the Health Professions Procedural Code (the “Code”), which is Schedule 2 to the Regulated Health Professions Act, 1991, S.O. 1991, c. 18, as amended.

Subsection 93(1) of the Code, which is concerned with failure to comply with
these orders, reads: Every person who contravenes an order made under … section 45 or 47… is guilty of an offence and on conviction is liable,
(a) in the case of an individual to a fine of not more than $25,000 for a first offence and not more than $50,000 for a second or subsequent offence; or
(b) in the case of a corporation to a fine of not more than $50,000 for a first offence and not more than $200,000 for a second or subsequent offence.

Indexed as:
Ontario (College of Physicians and Surgeons of Ontario) v.

Vasovich, 2015 ONCPSD 32
THE DISCIPLINE COMMITTEE OF THE COLLEGE OF PHYSICIANS AND SURGEONS OF ONTARIO
 
IN THE MATTER OF a Hearing directed by the Inquiries, Complaints and Reports Committee of the College of Physicians and Surgeons of Ontario pursuant to Section 26(1) of the Health Professions Procedural Code being Schedule 2 of the Regulated Health Professions Act, 1991, S.O. 1991, c. 18, as amended.

B E T W E E N:

THE COLLEGE OF PHYSICIANS AND SURGEONS OF ONTARIO

- and -

DR. INGE VASOVICH

PANEL MEMBERS:
D. DOHERTY (CHAIR)
DR. P. CASOLA
S. BERI
DR. P. POLDRE
DR. H. SCULLY
Hearing Date: June 30, 2015
Decision Date: June 30, 2015
Release of Written Reasons: August 12, 2015

PUBLICATION BAN
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DECISION AND REASONS FOR DECISION
The Discipline Committee (the “Committee”) of the College of Physicians and Surgeons of Ontario heard this matter at Toronto on June 30, 2015. At the conclusion of the hearing, the Committee delivered a written order that included a finding of professional misconduct and a penalty and costs order, with written reasons to follow.

THE ALLEGATIONS

The Notice of Hearing alleged that Dr. Vasovich committed an act of professional misconduct:
1. under paragraph 1(1)2 of Ontario Regulation 856/93 made under the Medicine Act, 1991 (“O. Reg. 856/93”), in that she has failed to maintain the standard of practice of the profession; and

2. under paragraph 1(1)33 of O. Reg. 856/93, in that she has engaged in an act or omission relevant to the practice of medicine that, having regard to all the
circumstances, would reasonably be regarded by members as disgraceful,
dishonourable or unprofessional.

RESPONSE TO THE ALLEGATIONS
Dr. Vasovich admitted the second allegation of professional misconduct in the Notice of Hearing, that she has engaged in an act or omission relevant to the practice of medicine that, having regard to all the circumstances, would reasonably be regarded by members as
disgraceful, dishonourable or unprofessional. Counsel for the College withdrew the first allegation of professional misconduct in the Notice of Hearing, that she failed to maintain
the standard of practice of the profession.

THE FACTS

The following facts were set out in an Agreed Statement of Facts and Admission that was filed as an exhibit and presented to the Committee:
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1. Dr. Inge Vasovich (“Dr. Vasovich”) graduated from the University of Western Ontario Medical School in 1970 and completed her LMCC examinations in 1971.

She has held a certificate of registration authorizing independent practice from the College of Physicians and Surgeons of Ontario (the “College”) since July 7, 1971.

Dr. Vasovich is a general practitioner practising in Hamilton, Ontario.

2. In about 1996, Dr. Vasovich commenced a romantic relationship with Mr. X.

When the relationship commenced, Mr. X was under the care of another family
physician and Dr. Vasovich had never provided medical care to him.

3. From 1996 to 2003, inclusive, Dr. Vasovich provided medical care to Mr. X,
which included referring him to specialists for his various health problems, receiving reports from treating specialists, and interpreting test results and reports.

She is regularly listed on those reports as Mr. X’s family physician.

4. There is no evidence that Dr. Vasovich ever performed physical examinations on
Mr. X, or provided psychotherapy to him. Nor did Dr. Vasovich bill OHIP for any
care she provided to him.

5. In 2004, Mr. X was diagnosed with heart disease and subsequently underwent by- pass surgery. Mr. X and Dr. Vasovich’s relationship ended in February 2005. For a period of time after the relationship ended, Mr. X had another family physician.

However, he returned to Dr. Vasovich who remained involved in his care. At
various points until Mr. X’s death in 2012, she referred him to specialists, prescribed and renewed medications for him, received, reviewed and interpreted
consult reports and test results, and attended appointments with him. Towards the end of Mr. X’s life, Dr. Vasovich was in daily communication with his personal support workers, and provided them with instructions on his medications.

6. Mr. X died at Hospital A in City 1 in June 2012.

7. A copy of the records Dr. Vasovich kept with respect to Mr. X, which consist of
lab reports and reports from other treating physicians, is attached at Tab 1 [to the Agreed Statement of Facts and Admission]. Dr. Vasovich also prepared a
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cumulative patient profile and a chronology in respect of Mr. X’s care. These documents, along with typewritten transcriptions, are attached at Tabs 2 and 3 [to the Agreed Statement of Facts and Admission], respectively.

8. This matter was brought to the College’s attention by a family member of Mr. X.

The nature and extent of the relationship that existed between Dr. Vasovich and
Mr. X between the end of their relationship in early 2005 and Mr. X’s death in 2012 is the subject of court proceedings, in which Dr. Vasovich claims a financial interest in Mr. X’s estate. During this time, Dr. Vasovich was involved in Mr. X’s care as outlined in paragraph 5 above. Mr. X lent Dr. Vasovich money, including 2 loans of $30,000.00 each in 2008, evidenced by the notes attached at Tab 4 [to the Agreed Statement of Facts and Admission]. Other sums changed hands
between Mr. X and Dr. Vasovich after 2008.

9. Throughout her relationship with Mr. X, Dr. Vasovich issued prescriptions to Mr.

X in circumstances that were not for minor conditions and did not constitute an emergency. Some of these prescriptions were repeats of prescriptions initiated by Mr. X’s treating specialists. Drugs for which Dr. Vasovich issued prescriptions included antibiotics, Lorazepam, Detrol and Rivaroxaban. Pharmacy printouts of Dr. Vasovich’s prescriptions for Mr. X from a Pharmacy in City 2 between June 2009 and May 2012 are attached at Tab 5 [to the Agreed Statement of Facts and
Admission].

10. The College policy on Treating Self and Family Members provides, among other things, that physicians should not treat their family members or other individuals in relation to whom the physician has personal or emotional involvement that may render the physician unable to exercise objective professional judgment in reaching diagnostic or therapeutic decisions (“family or other close individuals”),
except for minor conditions or in an emergency situation, and only when other qualified health professions are not readily available. Where it is necessary to treat family or other close individuals, physicians must transfer care to another
5
 
qualified health professional as soon as is practical. A copy of the policy is
attached at Tab 6 [to the Agreed Statement of Facts and Admission].

11. By treating Mr. X in circumstances that did not constitute an emergency, and treating him when other health care professionals were available, Dr. Vasovich
contravened the College Policy.

ADMISSION
12. Dr. Vasovich admits the facts specified above and admits that, based on these facts, she has engaged in conduct or an act or omission relevant to the practice of medicine that, having regard to all the circumstances, would reasonably be regarded by members as disgraceful, dishonourable or unprofessional, contrary to paragraph 1(1)33 of O. Reg. 856/93.

FINDING
The Committee accepted as true all of the facts set out in the Agreed Statement of Facts and Admission. Having regard to these facts, the Committee accepted Dr. Vasovich’s admission and found that she committed an act of professional misconduct, in that she has engaged in an act or omission relevant to the practice of medicine that, having regard
to all the circumstances, would reasonably be regarded by members as disgraceful, dishonourable or unprofessional.

PENALTY AND REASONS FOR PENALTY AND COSTS
Counsel for the College and counsel for the member made a joint submission as to an appropriate penalty and costs order. The Committee is aware that a joint submission should be accepted unless to do so would be contrary to the public interest and would bring the administration of justice into disrepute. The Committee is also aware of the accepted principles that guide the determination of an appropriate penalty. First and foremost is protection of the public from further misconduct by the physician. The penalty must also provide both specific and general deterrence. It must send a clear 6
 
message that such misconduct will not be tolerated. In addition, the penalty must reflect the profession's disapproval of the misconduct and maintain public confidence in the College's ability to self-govern in the public interest. Aggravating and mitigating factors must be considered, and, where appropriate, the potential for rehabilitation of the physician must be taken into account.

Dr. Vasovich is a general practitioner practising in Hamilton, Ontario, who since 1971 has held a certificate of registration authorizing independent practice from the College of Physicians and Surgeons of Ontario. Dr. Vasovich and Mr. X’s relationship ended in February 2005. Mr. X subsequently died at Hospital A in City 1 in June 2012. From
1996, up until his death in 2012, other than a brief hiatus, Dr. Vasovich provided medical care to Mr. X. This included referrals to specialists, prescribing and renewal of medications, interpretation of tests and ordering laboratory investigations. The Committee received in evidence extensive volumes of material (Exhibit 2) regarding the
care provided by Dr. Vasovich to Mr. X. The Committee noted that Mr. X was being treated for a number of serious medical conditions, utilizing multiple medications. It was clear that Dr. Vasovich was treating a complex and potentially difficult patient, even
though he was in a relationship with her. Dr. Vasovich’s treatment of and prescribing for Mr. X clearly and grossly fell outside of the guidelines of the College’s Policy Statement #7-06 “Treating Self and Family Members" (Exhibit 4). The College’s policy, approved
by Council in November 2001, outlines the guidelines that every physician in Ontario must follow in treating either themselves or their family members. It provides that "physicians are not permitted to diagnose or treat either themselves or family members,
except for minor conditions or in emergency situations, and then only when another physician is not readily available". The Committee did recognize that Dr. Vasovich did not bill OHIP for her services, and thus received no direct financial gain through the medical care she provided to Mr. X. Furthermore, there was no evidence of ongoing provision of controlled or restricted substances to Mr. X. It was also recognized that much of Mr. X’s care was directed by the multitude of specialists that he had seen on referral from Dr. Vasovich. At the same time the central role of the family physician/general practitioner, the role which Dr. Vasovich assumed in the management 7
 
of the treatment of her patient, cannot be overemphasized in terms of its critical mandate in organizing, integrating and orchestrating patient care. Family physicians are in a unique and important position in the provision of care for their patients. They are the key medical providers to the patient due to their global perspective on their patients’ medical condition. They ultimately direct the care of their patients regardless of the number of consultants/specialists who may be involved.

As a mitigating factor, the Committee does recognize that this was the first appearance by Dr. Vasovich before the Discipline Committee. There is no evidence that she treated other family members.

The Committee believes that the penalty jointly proposed by the parties achieves both specific and general deterrence. It also reflects the profession’s disapproval of the misconduct by Dr. Vasovich. Dr. Vasovich's care of Mr. X grossly and clearly fell outside of the policy established by the College in 2001. Physicians must recognize that
treatment of themselves or family members is fraught with hazard given the
unpredictability of medical conditions. Even "simple" problems can at times and do become complex and the physician can then be placed in a compromised position, objectivity being lost, resulting in compromised decision making and care.

The Committee is aware that a four-month suspension is significant for treatment of a family member, but given Dr. Vasovich's serious disregard for the College policy over an extended period of time, believes such a suspension is warranted. The proposed order also provides for remediation, in that Dr. Vasovich is required to successfully complete the course "Understanding boundaries and managing the risks inherent in the doctor- patient relationship”. Furthermore, the order by the Discipline Committee complements a
practice restriction on Dr. Vasovich from an Undertaking, effective May 11, 2015
(Exhibit #3), which among other restrictions, requires Dr. Vasovich to retain a clinical supervisor to review her charts and observe her patient care. This order continues in place until Dr. Vasovich makes an application to the Inquiries, Complaints and Reports
Committee for review. The Committee finds that the order it has made, in combination 8
 
with the practice restriction, will ensure protection of the public through remedial measures and ongoing third party monitoring. The Committee therefore accepted the joint
submission on penalty and costs made by the parties.

ORDER

Having stated its finding of professional misconduct, the Committee ordered and directed in its order of June 30, 2015, on the matter of penalty and costs, that:

2. the Registrar suspend Dr. Vasovich’s certificate of registration for four (4)
months, effective thirty (30) days from the date of this Order.

3. Dr. Vasovich abide by the terms of the College’s Policy on Practice Management
Considerations for Physicians Who Cease to Practise, Take an Extended Leave of
Absence or Close Their Practice Due to Relocation, a copy of which is attached
[to the Order] as Appendix A.

4. the Registrar impose the following term, condition and limitation on the
certificate of registration of Dr. Vasovich:
(a) Dr. Vasovich must successfully complete, at her own expense, the
Understanding Boundaries and Managing the Risks Inherent in the Doctor-
Patient Relationship course, within 12 months of the date of this Order.

5. Dr. Vasovich appear before the panel to be reprimanded.

6. Dr. Vasovich pay costs to the College in the amount of $4,460.00, within 30 days
of the date of this Order.

At the conclusion of the hearing, Dr. Vasovich waived her right to an appeal under subsection 70(1) of the Code and the Committee administered a public reprimand.

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TEXT of PUBLIC REPRIMAND

Delivered June 30, 2015 in the case of the
COLLEGE OF PHYSICIANS AND SURGEONS OF ONTARIO
and DR. INGE VASOVICH

Dr. Vasovich, the Panel wishes to express its strong disapproval for the conduct
which brought you before us today. The College Physicians and Surgeons of Ontario issues policies to its members in order to protect patients and prevent them from harm.

Your flagrant disregard of the College policy not to treat family members is very disturbing. Your behaviour expresses a lack of respect for your governing body and its mandate of protecting the public.

Self-governance is a privilege and it is vitally important that all members hold this privilege dear. It is disheartening to see you before us in a disciplinary proceeding following a 40-year career, which was previously unmarred. We trust that the remedies that you have agreed to participate in will prevent any further breaches.

Thank you. You may sit down.
 
 


Decision: Download Full Decision (PDF)
Appeal: No Appeal
Hearing Date(s): June 30, 2015

Concerns

Source: Member
Active Date: September 30, 2016
Expiry Date:
Summary:
Summary of the Undertaking given by Dr. Inge Vasovich to the College of Physicians and Surgeons of Ontario, effective September 30, 2016:

Dr. Vasovich was the subject of a College investigation into whether she failed to maintain the standard of practice of the profession and/or was incompetent. In the face of this investigation, Dr. Vasovich voluntarily resigned from the College and has agreed never to apply or reapply for registration as a physician in Ontario or any other jurisdiction.

See attached PDF for full undertaking.
Download Full Document (PDF)